Sit Down and Listen

Paul Hudson, Vice President

Patient satisfaction surveys ask respondents to evaluate "The degree to which the physician took time to listen to you" by marking excellent, very good, good, fair or poor. The hospital's expectation is that the "top box" (excellent) can and will improve. We believe that that this can be accomplished by increasing the frequency of specific physician behaviors: an introduction, sitting down, use of scripted phrases, and multiple encounters.

There are effective ways to demonstrate concern for a patient even when you're trying to do things quickly.

How you enter the exam room is important

Walk into the room with a smile, apologize for the wait, introduce yourself to all those assembled (remember to include the family), shake the patient's hand, call the patient by name and when possible and appropriate, sit down. Sitting down places the physician at or below eye level and reassures the patient that you are paying attention (listening). Sitting down relaxes the patient so that he or she will communicate more openly.

Now that you've set the stage, it's time to listen

After a general prompt about the reason for their visit to the ED, let the patient talk for a minute without interruption – you will get information you otherwise might have missed. When the patient has finished speaking, paraphrase what they've said to confirm that you correctly understand their concerns.

It helps to have and use effective communication tools

The consistent use of conversation that has been proven successful in advancing patient satisfaction is called "scripting'. You may want to consider utilizing one or more of these phrases as part of the patient encounter:

• "How can I help you?"
• "I'm sorry this happened to you."
• "Do you have any questions? I have plenty of time."
• "You'll probably think of some questions. Here's a notepad to write them down."
• "Have you thought of any other information you might need to know?"
• "We have more pain medication than you have pain."
• "Come back any time. We never close."
• "I'm going to be here all night. If you have any questions when you get home, give me a call."
• "I'll be on duty Tuesday and Wednesday nights. If you need to see me, feel free to come back then."

Give evidence of your continuing interest in and involvement with the patient's care

Check on the patient's progress with multiple, brief encounters. When things are busy, at least stick your head in an exam room and let the patient know you'll be with them soon. As information becomes available, provide an update to the patient.

Summary

• Introduce yourself in a professional fashion
• Address family members - bring them into the encounter
• Establish a high level of professionalism and courtesy
• Provide information as it becomes available with frequent updates
• Check the patient's progress using multiple, brief encounters
• Sit down

Remember...

• Patients won't remember what you said to them
• Patients won't remember what you did to them
• But they will always remember how you made them feel

Sources

• "Patient Satisfaction Scores: Improving Them in Your Emergency Department" Presentation notes from a program at the ACEP Scientific Assembly, October 18, 2004, Thom Mayer, MD, FACEP.
• Leadership for Great Customer Service. Satisfied Patients, Satisfied Employees. Health Administration Press 2004, Thom Mayer and Robert Cates.
• Hardwiring Excellence. Fire Starter Publishing 2003. Quint Studer.
• "Variables Contributing to Emergency Department Patient Satisfaction" Academic Emergency Medicine Volume 12, Number 5 ,Catherine A. Marco
• "Towards a Bold Love for ED Systems: 25 Practical Strategies to Improve Emergency Department Patient Satisfaction", The Press Ganey Satisfaction Monitor, July / August 2000, James A. Espinosa, MD, FACEP